Finger pebbles: A common finding in diabetes mellitus

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      Several authors have now described the relatively common occurrence of thickening of the skin on the dorsum of the fingers and hands in persons with diabetes mellitus, and skin thickening in these patients has been documented histologically for other body locations. To date, the presence of finger and hand skin thickening has been determined by an examination difficult to objectify—palpation and attempted tenting of the affected area. In a survey of sixty subjects with diabetes, it was found that forty-five patients (75%) have a visual marker for skin thickening, that is, a pebbly appearance of the knuckle and distal finger skin. Similar changes were present in eleven of fiftytwo control subjects (21%). A limited histologic study indicates that the epidermis and papillary dermis are primarily responsible for this thickening. A pebbly appearance of volar finger skin may be a more easily recognized marker of diabetic skin thickening.
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        • Rosenbloom AL
        • Silberstien JH
        • Lozotte DC
        • et al.
        Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease.
        N Engl J Med. 1973; 305: 191-198
        • Seibold JR
        Digital sclerosis in children with insulindependent diabetes mellitus.
        Arthritis Rheum. 1982; 25: 1357-1361
        • Garza-Elizondo MA
        • Diaz-Houanen E
        • Franco-casique JJ
        • et al.
        Joint contractures and seleroderma-like skin changes in the hands of insulin-dependent juvenile diabetics.
        J Rheumatol. 1983; 10: 797-800
        • Fitzcharles MA
        • Duby S
        • Wadell RW
        • et al.
        Limitation of joint mobility (cheiroarthropathy) in adult noninsulindependent diabetic patients.
        Ann Rheum Dis. 1984; 43: 251-257
        • National Diabetes Data Group
        Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance.
        Diabetes. 1979; 28: 1039-1057
        • Sugrue D
        • McEvoy M
        • Dempsy J
        • et al.
        Diabetic stiff hand syndrome.
        Isr J Med Sci. 1983; 152: 152-156
        • Lawson PM
        • Maneschi F
        • Kohner EM
        The relationship of hand abnormalities to diabetes and diabetic retinopathy.
        Diabetes Care. 1983; 6: 140-143
        • Clark CV
        • Pentland B
        • Ewing D
        • Clarke BF
        Decreased skin wrinkling in diabetes mellitus.
        Diabetes Care. 1984; 7: 224-227
        • Buckingham BA
        • Uitto J
        • Sandborg C
        • et al.
        Scleroderma-like changes in insulin-dependent diabetes mellitus: Clinical and biochemical studies.
        Diabetes Care. 1984; 7: 163-169
        • Allison JR
        Knuckle pads.
        in: Demis DJ Clinical dermatology. vol. 1. Harper & Row, Publishers, Inc., Philadelphia1985: 1-3